New Tool May Help Brain Surgeons ‘See’ Invisible Cancer Tissue

I’ve often described brain surgeons as thieves in the night, sneaking in to remove as much of the cancer tumor as possible without touching the brain and without the brain ever knowing we were there.

Of course, we can’t do this without an arsenal of state-of-the-art tools and technologies. There’s now a new laser, currently in development and anticipated to go into clinical trials, that will enable neurosurgeons to isolate and remove brain cancer tissue even more accurately.

The laser uses an imaging technology called SRS microscopy to detect the edges, or “margins,” of a tumor – the area where tumor cells are just starting to infiltrate healthy cells. This is the most difficult area for surgeons to operate on because the cancer cells are so close to normal cells, and the risk of touching the brain – and potentially affecting an important brain function – is very high.

With the new laser, surgeons can differentiate the tiniest of tumor tissue from normal tissue on a microscopic level. Not only that, it’s done in real-time during the operation.

While SRS microscopy is not new, this is the first time that researchers are exploring its use in brain surgery, particularly for patients with glioblastoma multiforme, one of the most severe brain cancer types.

“We need better tools for visualizing tumor during surgery, and SRS microscopy is highly promising,” said Daniel Orringer, a lecturer in the department of neurosurgery at the University of Michigan and co-lead author of the study exploring SRS microscopy use for brain cancer surgery, which was published in Science Translational Medicine. “With SRS we can see something that’s invisible through conventional surgical microscopy.”

In this University of Michigan article, you can see the level of detail provided by SRS microscopy compared to bright-field microscopy, an imaging tool that many neurosurgeons currently use in the operation room.

It’s not good enough for us surgeons to treat patients with what we know now. We want to move beyond what we know and ultimately provide cures for a whole variety or disorders that affect the brain and spinal cord, including brain cancer. Innovative technologies like this new laser take us one step closer.